Emergent Objects,Developing Practices: Human‐Nonhuman Interactions in a Reiki Training

Over the last three decades, sociologists have expanded the scope of sociological analysis to include nonhuman objects. We build on these works to address the role of nonhuman, nonphysical objects in social interaction. Through participant observation at a Reiki training course, we examine how students learned to identify, experience, and meaningfully interact with Reiki energy, a nonhuman, nonphysical object. We show how Reiki energy emerged as a significant interactant through the following processes: participants in the class historicized Reiki; they defined the capacities and consequences of Reiki; and they learned to detect Reiki energy's apparent presence in their bodies. We then show how Reiki energy resisted the initial definitions and expectations of it, leading participants to redefine the energy's qualities and develop new practices to accommodate its emerging capacities. These findings support theoretical claims about humans' ability to “do mind” for nonhuman objects and the temporally emergent qualities of material agency.     

Conducting the medical history

A key portion of the medical evaluation of child sexual abuse is the medical history. This differs from interviews or histories obtained by other professionals in that it is focuses more on the health and well-being of the child. Careful questions should be asked about all aspects of the child's medical history by a skilled, compassionate, nonjudgmental, and objective clinician. Often the diagnosis of sexual abuse is based only on the medical history. The history can be further understood by knowledge of how children are abused and their reactions to it. By addressing the child's and parent's concerns, reassurance can also be provided about what is normal and abnormal with the child's body.     

Socialising disease: medical categories and inclusion of the aged1

When older peoples’ troubles are categorised as social rather than medical, hospital care can be denied them. Drawing on an ethnography of older people admitted as emergencies to an acute medical unit, the article demonstrates how medical categories can provide shelter for older people. By holding their clinical identity on medical rather than social grounds, physicians who specialise in gerontology in the acute medical domain can help prevent the over‐socialising of an older person's health troubles. As well as helping the older person to draw certain resources to themselves, such as treatment and care, this inclusion in positive medical categories can provide shelter for the older person, to keep at bay their effacement as 'social problems’. These findings suggest that contemporary sociological critique of biomedicine may underestimate how medical categorising, as the obligatory passage through which to access important resources and life chances, can constitute a process of social inclusion.     

Is There a Place for Biopsychosocial Formulation in a Systemic Practice?

There is a long history of literature concerning integrative practice and how a systemic practice can fit with other models of therapy Much of this literature has focused on establishing a space for systemic therapy within the dominant medical paradigm, and exploring how the medical model can be enhanced by systemic ideas. The outcome has been better practice, especially in child and adolescent mental health. Interestingly, however, there has been less discussion of the converse: the family therapy literature has rarely considered whether or not systemic practice itself can be enhanced by ideas from the dominant medical model. This article proposes that a biopsychosocial formulation can enhance systemic practice by: (I) holding clinicians accountable for their thinking; (2) facilitating a rigour and attention to detail that may prove useful when therapy falters; (3) opening up other possibilities for intervention; and (4) providing a way to engage with the dominant medical paradigm and support clients in negotiating their way through this system. Potential problems nevertheless arise when integrating a biopsychosocial formulation into a systemic framework. This article identifies these problems and presents ideas for how they can be managed in practice.     

The challenges of clinical psychopharmacological management

Collaboration among health care providers in the treatment of mental health patients with comorbid medical and neurological conditions can be very challenging, especially with pharmacotherapy management where medications are prescribed by multiple providers. An individual example of a patient with a number of comorbid conditions taking multiple concurrent medical and psychotropic medications is described to highlight how challenging such situations can be. Medical conditions or medical medications might trigger or exacerbate symptoms of mental disorders. Psychotropic drugs may cause adverse effects that come to the attention of medical providers. Accurate communication among providers-and between the patient and providers-is important to avoid misinformation or misunderstandings in the care of patients with complicated problems.     

以医学院校为背景的生物医学工程领域工程硕士培养模式探索

结合医学院校特点,探讨了以医学院校为背景的生物医学工程领域工程硕士培养模式的创新与优化,从培养目标、课程设置、教学内容、学位论文等方面进行了探索和优化,以不断完善和规范生物医学工程专业工程硕士的培养过程。     

The interpreter as institutional gatekeeper: The social-linguistic role of interpreters in Spanish-English medical discourse

Increases in immigration have led to an enormous growth in the number of cross-linguistic medical encounters taking place throughout the United States. In this article the role of hospital-based interpreters in cross-linguistic, internal medicine ‘medical interviews’ is examined. The interpreter's actions are analyzed against the historical and institutional context within which she is working, and also with an eye to the institutional goals that frame the patient-physician discourse. Interpreters are found not to be acting as ‘neutral’ machines of semantic conversion, but are rather shown to be active participants in the process of diagnosis. Since this process hinges on the evaluation of social and medical relevance of patient contributions to the discourse, the interpreter can be seen as an additional institutional gatekeeper for the recent immigrants for whom she is interpreting. Cross-linguistic medical interviews may also be viewed as a form of cross-cultural interaction; in this light, the larger political ramifications of the interpreters' actions are explored. ‘Interpreters are the most powerful people in a medical conversation.’ Head of Interpreting Services at a major private U.S. hospital, May 1999.     

Deconstructing Disability and Neurodiversity: Controversial Issues for Autism and Implications for Social Work

Disability is a socially constructed concept that can be viewed from either a medical or a social perspective. Autism, a developmental disability, can be viewed from the medical model of disability or through a new perspective brought forth by the autistic community and aligning with the social model termed neurodiversity. Using the medical model and a lens of neurodiversity, we can deconstruct the controversial issues surrounding autism and provide insights for social workers and other professionals working with the community of the disabled.     

THE EMERGING ROLE OF THE MEDICAL SOCIOLOGIST IN PALLIATIVE CARE SETTINGS

The demographics of a rapidly aging society and the chronic nature of contemporary illness intersect in the twenty-first century to confront medicine with the challenge of reenvisioning health care at life's end. Using analytic, interpretive, and reflexive tools, the medical sociologist can assist health care teams in improving quality of life terminally ill patients and their caregivers. In this article, we explore the role of the medical sociologist in palliative care settings, discuss ways to integrate that role into the day-to-day processes of palliative medicine, and identify three areas of intervention where medical sociologists can bring a unique perspective to end-of-life settings. We conclude by examining impediments to the inclusion of the medical sociologist on the clinical team and discussing how these barriers can be addressed.     

Physical Disability in 1986 and Beyond: A Response to Simon Brisenden

The report of the Royal College of Physicians Physical Disability in 1986 and Beyond has been criticised by some disabled people because it deals exclusively with medical aspects of disability and not with the whole range of services and resources that disabled people require. This criticism is unfair since it would be totally inappropriate for a committee composed only of doctors to make recommendations other than of a medical or N.H.S. managerial nature. There are many deficiencies in the medical support of disabled people, particularly those with complex impairments and those with brain damage. Correcting these deficiencies needs a change in medical practice and in the N.H.S. resources devoted to rehabilitation medicine. The College report has defined very clearly the scale of this problem, suggested specific practical solutions and how they should be audited, and provides guidelines which all those concerned with disabled people can use to check on the medical services that should be available and to identify those who are responsible for providing them.     

Psychotherapeutic approaches to chronic and episodic physical disorders

Patients experiencing chronic illnesses or psychophysiological disease in which the etiology is unclear and medical treatment less than maximally effective can be helped by therapy which takes into account relevant psychological and social factors. Social workers can, working with medical practitioners, define and develop effective psychotherapeutic approaches.     

Quality of medical care by central government health scheme--a study

This study reports findings on the time spent by CGHS medical officers per patient in different medical care activities for 2,115 patients, as obtained by time study technique. This study was conducted during the year 1976-77. The average observed time spent by the medical officer per patient was found to be 117.15 seconds per patient. The medical officers elicited only main complaints without asking past and family history in 84.44 per cent of patients and the average time spent on history taking was 42 seconds per patient which also included examination of identify card, recording of name, age and sex of the patients. Physical examinations were conducted in only 23.88 per cent of patients and the time spent per patient was 45.93 seconds. The advice for investigations was imparted in 2.60 per cent of patients, though the facilities for routine laboratory examinations were available in the dispensaries. Advice to the patient regarding dietary instructions and general advice was exclusively given in only 5.20 per cent of cases whereas the family planning/health education advice to the patients was given only in 0.76 per cent of patients. The medical officers are aware of the inadequate quality of medical care provided to the beneficiaries and they felt they should at least spend 6.83 minutes for an old patient and 12.42 minutes for the new patient. Probably they are not able to do so because of long queues in the dispensaries during peak hours. Hence, to improve the overall medical care and provide comprehensive care to the beneficiaries it is suggested that the medical officers can be given certain beneficiary population and made responsible to them.     

The 'Right' to Die: The Case for and against Voluntary Passive Euthanasia

The capacity to sustain human biological life by biomedical technology and improved life support systems has reawakened debate on the 'right' to die and euthanasia. How can the medical and allied health professions resolve the dilemma between a basic respect for human life and the changed conditions of biomedical technology? Drawing upon the philosophic, religious, and medical traditions of the West, this paper explores and weighs the arguments for and against voluntary passive euthanasia. It is concluded that infants and children, minors, senile, psychotic, mentally retarded, and irrecoverably brain damaged persons should not be considered candidates for euthanasia because they are not competent to judge. Involuntary and active euthanasia are condemned as outside the religious and medical traditions of the West. This leaves a small group of candidates for euthanasia who are mentally competent and fully informed of their chances for prolongation of life. Consideration should also be given to the family of the dying person.     

THE DIFFUSION OF MEDICAL TECHNOLOGY: SOCIAL NETWORK ANALYSIS AND POLICY RESEARCH

The purpose of this article is to demonstrate how social network analysis can be used to provide information for policy decisions pertaining to physicians' adoption and utilization of new medical technology. Interviews and hospital records were used to obtain data on refenals, consultations, discussions, and on-call coverage; utilization of a computer-based hospital information system; and personal and practice characteristics from 24 physicians who belong to a private group practice. The results of a block-model analysis suggest that the physician's relative position in the network is an important determinant of his/her participation in the diffusion process. A number of policy implications related to the introduction of new medical technology into practice settings are discussed.     

中国基本医疗保险的实际参保率及其分布特征:基于多源数据的分析

全民覆盖是基本医疗保险降低国民医疗费用负担的前提条件。中国基本医疗保险是否实现了全民覆盖仍存在争议。本文利用多源调查数据,分析了我国基本医疗保险实际参保率及其分布特征。不同来源的数据基本证实,2015-2016年,中国仍有超过10%的国民没有参加任何一项基本医疗保险制度。其中,城镇居民、非农户口和没有户口的居民、东北地区、年轻人、儿童、未就业人群、低收入人群、在校学生以及流动人口基本医疗保险实际参保率更低。城乡居民实行自愿参保,因管理部门分割、信息系统不统一导致的重复参保以及因财政补贴制度导致的户籍地参保等制度设计,是导致基本医疗保险未能实现全民覆盖的根源。要实现基本医疗保险全民覆盖,解决国民医疗后顾之忧,未来我国基本医疗保险应实行强制参保、以家庭为单元参保、常住地参保,建立全国统一的基本医疗保险信息系统,并鼓励发展补充性医疗保障制度。     

Medical sociology: some tensions among theory, method, and substance

Why is it that quantitative and qualitative researchers on health issues often have divergent findings and conclusions? Exploration of such differences can be a useful way of bringing separate intellectual enclaves in medical sociology together and also can stimulate future inquiries. Some differences can be resolved by more precise definitions, by comparable frequency and timing of measurement, and by careful evaluation of meaning contexts. The triangulation of methods, using diaries as a bridge between surveys and qualitative measurement, offers particular promise. Improved theory on the relationships of method to data, and more attention to behavioral sequences and the social context of measurement, can serve as a stimulant to innovative solutions.     

高校学生自我医务监督意识培养思考

文章通过调查法、文献资料法、访谈法等对高校学生的损伤进行制因分析，最终得出结论：高校学生虽然心智已经成熟，但是在日常学习锻炼中自我医务监督意识较差、不科学处理损伤等，从而导致不必要的运动损伤严重。建议高校能够开设提高自我医务监督意识的相关选修课程，为更好的增强学生的医务监督意识提供实践和参考。     

EXPOSURE TO MARITAL AND FAMILY THERAPY IN MEDICAL SCHOOL: A STUDENT PERSPECTIVE

Most marital and family therapists, both medically and nonmedically trained, regularly interact with physicians on a professional basis. Though some physicians receive specific training in marital and family therapy in their postgraduate residency programs, (notably those in psychiatry and family medicine), for many, the only academic exposure they receive to this field comes during a 6- to 10-week clinical clerkship in psychiatry during their third or fourth year of medical school. No study could be located which examined marital and family therapy training in undergraduate medical education. The purpose of this study was to gain a better understanding of the level of marital and family therapy training in medical school and to provide information concerning physicians who are not family therapists, and how much knowledge about the field they can be expected to have.     

Laughter in medical interaction: From quantification to analysis,and back

This study discusses the use of quantification in analysing interactional practices, especially in conversation analytical work. The paper concentrates on laughter in medical interaction and starts from a quantitative point of view. West (1984) found certain statistical patterns of laughter in medical interaction: the patients laugh more than the doctors and most laughter is not reciprocated, i.e. the interactants mostly laugh alone. This statistical pattern is also found in Finnish data but it is approached again from the micro‐analytical point of view and some features of it are problematised through analysing in more detail: (1) the ways in which laughter is made relevant; (2) how laughter is responded to; and (3) the interactional functions laughter can have. The paper shows that Schegloff’s (1993) critique of quantitative interactional work is indeed called for, but nevertheless also presents advantages of quantification: the distribution of laughter between the participants in medical interaction turned out to be an interesting issue, one which is revealing of their different interactional roles and footings.